The Power Of ACL Surgery

An anterior cruciate ligament (ACL) injury is one of the more concerning joint issues, particularly for athletes. This injury is also common in contact sports, with over 400,000 reported yearly. ACL injuries can be classified as stretched, partially torn, or completely ruptured. In the more severe cases, the individual may choose ACL surgery. Thanks to innovative surgical techniques, what was once considered a career-threatening injury is no longer the case.

Your knee's ACL

The ACL is a strong ligament that connects the thigh bone or femur with the tibia or shin bone. Along with the posterior cruciate ligament (PCL), the ACL stabilizes the knee. By preventing excessive forward movement and providing rotational stability, athletes can run, jump, and change direction with speed and force. Like any ligament, the ACL is at risk of damage, either over time or due to an acute injury. Should there be a tear, the stability and directional movements are limited significantly.

Causes and the impact of injury

The ACL is a strong ligament capable of withstanding almost 500 pounds of pressure. However, without a healthy ACL, athletic performance is hindered. Most ACL injuries are non-contact. An athlete attempts to stop, change direction, or pivot to increase the chances of success. Collisions in the sporting arena or a blow to the leg or knee can also cause a ruptured ACL. Some sports, like soccer, skiing, basketball, and football, have the highest risk of ACL injuries. Studies also show that female athletes in these fields are more likely to have ACL tears.

Why choose ACL surgery?

An ACL injury can be devastating for an athlete. A severe rupture cannot heal naturally as the ligament is irreparably damaged. The injury significantly impacts athletic performance, with even basic functions like running, jumping, or changing direction reduced. Even daily activities like walking, climbing stairs, or long periods of standing feel difficult. ACL surgery is an immediate consideration for athletes looking to return to sports at the same competitive level as before. More importantly, the surgery ensures a better quality of life.

Getting ready for surgery

ACL surgery is only considered after a careful, deliberate review by an orthopedic surgeon. The surgeon uses magnetic resonance imaging (MRI) and other testing to confirm the extent of ligament damage. Most cases require ACL reconstruction, which replaces the damaged ligament with a stronger tendon. Most surgeons will recommend some form of pre-surgery physical therapy in the days leading up to the procedure. This activity helps strengthen the knee, reduce pain, and speed up healing. Getting mentally prepared is also vital for the patient. A strong support group, stress management, and communication with doctors increase the chances of success.

Let's start surgery

An orthopedic surgeon performs ACL surgery. The patient is placed under local or general anesthesia for maximum comfort. ACL surgery was once performed with large, open incisions. Now, almost all surgeons use arthroscopic repair. With small incisions, the surgeon can use a scope to view the damaged knee. An autograft, a replacement tendon from the patient's body, is prepared to replace the ligament. Sometimes, a donor's allograft or tendon is harvested for use.

A delicate process

The surgeon removes all the damaged ACL tissue from the knee. In some cases, additional steps, like a meniscus repair, are performed. Once all the damaged material is gone, the surgeon drills holes in the tibia and femur. Strong wires will pass through these holes to anchor the new tendon in a manner that resembles the previous ACL. The graft is threaded through the holes and secured in place using screws or other metal fixation objects. The surgeon will test the integrity of the tendon, ensuring maximum stability. From there, the incisions are closed with sutures or surgical staples, and the leg is bandaged accordingly.

Time for rehab

After the procedure, thanks to outpatient options, the patient can often leave on the same day. However, the medical team will perform x-rays and other tests first to ensure the tendon replacement is successful. Rehabilitation is the next step that starts almost immediately, as surgery is only the start. The athlete must regain strength and function and get accustomed to the new ligament. This process is long and difficult, lasting several months. Strength, stability, and flexibility exercises are on the menu, increasing with intensity each month.

Back in the game

Usually, after 6 months, the patient should fully recover and can play sports again. However, additional training is needed to reach peak match fitness. Overall, ACL recovery may take 9-12 months. The athlete should also work on building mental strength and resilience. A common concern is the re-injury of the joint. There is sometimes a lack of trust in the knee and an unwillingness to give maximum effort in the initial months after recovery. With the right confidence and support, this, too, can be overcome. ACL surgery is the premier option for ACL tears to resume sports faster and better than ever.